Clinic Report Of24Cases Of Primary Mediastinal Lymphoma

Objective:To discuss the clinical characteristics, diagnosis and treatment of primary mediastinal lymphoma so as to make a further clinical understanding of the disease. Methods:Clinical data from24patients of Shandong Provincial Hospital in the recent8years who were diagnosed as primary mediastinal lymphoma was selected to analyse the clinical data comprehensively and telephone follow-ups with the prognosis.Results:From11male cases and13female cases (23cases visiting hospitals for all sorts of symptoms and1case being found through physical examination), we found the age of onset ranged from21to66years and the average onset age was42.25years including chestdistress (10cases) and superior vena cava syndrome (10cases), cough (6cases), lymphoadenopathy of neck (6cases), inguinal mass(2cases), pericardial effusion(6cases), bone marrow infiltration(3cases), lung infiltration (2caes). Most patients had lymphoadenopathy of the mediastinum. There were four misdiagnosed cases, the first visit of the misdiagnosis rate was16.67percent, all of which were diffuse large B-cell lymphoma. These cases were misdiagnosed as mediastinal lung cancer (2cases), invasive thymoma(1case), sarcoidosis (1case). There were6patients undergoing surgical operations. Among them, the three early single solitary nodular lymphoma patients who were diagnosed indefinably preoperatively and treated by complete surgical resection with fine prognosis were cured by surgical treatment. The remaining three cases of surgery were cured by radiotherapy and chemotherapy.18patients were cured by radiotherapy and chemotherapy after definite pathogenesis through puncture and other ways. Compared with the mean five years survival rate of patients undergoing surgery treatment (60%), the five years survival rate of the patients in this group was62.5%.18cases were diagnosed as non-Hodgkin’s lymphoma and6cases were diagnosed as Hodgkin’s lymphoma by Pathological result after surgery which cover16cases with DLBCL (66.67%),2cases with lymphocyte-rich classical HL(8.33%),4cases with nodular sclerosis classical HL (16.7%),2cases with LBL (8.33%)Conclusions:There are lots of mistakes in diagnosis of the first visit patients with the primary mediastinal lymphoma. The pathology types of primary mediastinal lymphoma centralize by NHL; For preoperatively unidentified diagnosis with mediastinal nodule surgery, directly resection achieved good results with surgical indications. For advanced cases with expanded resection preoperative or intraoperative, definite pathology is needed in order to gain the best treatment. The total prognosis of primary mediastinal lymphoma is unfavorable. Surgery makes some effect on primary mediastinal lymphoma, which is similar to common medical treatment. But for few samples, further large sample test is needed.